Re: Oral steroids- Ways of Increasing Bioavailability
Now unfortunately for the fine print. Who didn’t see this one coming?


Unfortunately our oral steroids aren’t the only thing that grapefruit juice will have this effect on here is a direct copy of a list (even this is not complete) of things grapefruit juice will have the same effect on:
https://secure.pharmacytimes.com/lessons/200303-02.asp




Table 2. Potential Interactions Between Grapefruit Juice and CYP3A4 Substrates
Drug Class Drugs(s) with Significant Grapefruit Juice Interaction Drug(s) with Negligible Grapefruit Juice Interaction Findings with Significant Interaction Implications with Significant Interaction
Anti-arrhythmics Amiodarone Increases AUC by 50% and peak plasma concentration by 84%. Both PR and QRS intervals were not significantly altered and systolic arterial pressure decreased slightly.42 Watch for arrhythmias and toxicity.
Quinidine Delays absorption of quinidine and inhibits the metabolism of active metabolite.43 Clinical significance is unknown.
Anti-convulsant Carbamazepine Increases AUC, peak and trough concentrations by 40%.44 Watch for signs of toxicity such as dizziness, ataxia, drowsiness, nausea, vomiting, tremor, and agitation. Monitor blood levels.
Anti-depressant Sertraline Trazodone Nefazodone Clomipramine Increases plasma concentrations. Watch for increases in side effects.
Anti-histamine Fexofenadine Desloratadine May decrease oral absorption and blood levels by inhibiting the organic anion transporting polypeptide.24 Clinical significance is unknown.
Anti-hypertensive Carvedilol Increases bio-availability of a single dose by 16%. Clinical significance is unknown
Losartan May reduce the AUC of the major active metabolite. May reduce effectivness of losartan but further studies are needed to determine significance.
Anxiolytics & hypnotics Diazepam Midazolam Triazolam Buspirone Alprazolam Increased plasma concentrations. Watch for possible increase in sedation.
Caffeine Decreases caffeine clearance.45,46 Watch for possible increase in side effects such as nervousness or insomnia.
Calcium channel blockers Felodipine Nicardipine Nifedipine Nimodipine Isaradipine Verapamil Amlodipine Diltiazem Increased plasma concentrations.47 Watch for toxicity, such as flushing, headache,t achycardia, and hypotension.
Cortico-steroids Methylprednisolone, oral Prednisone Increased plasma concentrations. Consumption of large amounts of grapefruit juice may increase the risk of adverse effects.
Budesonide Increases ora absorption.l Watch for hypercorticism.
Estrogens Ethinyl estradiol Increased plasma concentration. Clinical significance is unknown.
HMG-CoA reductase inhibitors Atorvastatin Lovastatin Simvastatin Fluvastatin Pravastatin Increased plasma concentrations. Increased toxicity such as GI complaints and muscle pain.
Immune modulators (immuno-suppressants) Cyclosporine Increased plasma concentrations of cyclosporine.48 Watch for signs of toxicity such as hepatotoxicity, renal toxicity, and increased immunosuppression.
Tacrolimus Possible increases in plasma concentrations. Watch for signs of toxicity such as nephrotoxicity, and increased immunosuppression.
Macrolide antibiotics Erythromycin Increased plasma concentration. Clinical significance is unknown.
Protease inhibitors Ritonavir Nelfinavir Saquinavir Indinavir Amprenavir Increases plasma concentrations. Watch for possible increased side effects.
Others Sildenafil Increased bioavailability.49
AUC = area under the curve; PR = pulse rate; GI = gastrointestinal.




NOTE: This will increase the potential for side effects for serious medications from blood pressure lowering medications to mood stabilizers. It will also increase the potency of caffeine and the ED drugs Viagra and Cialis so something very important to keep in mind since Priapism can occur and while you may think it is funny to have an erection for longer than 4 hours it can cause serious nerve damage and be extremely painful. Also keep in mind liver toxicity so please remember to use ALA and NAC while attempting any of this.














And as usual for my writeups:


Now for the disclaimer: I am an MD, but I cannot and will not give medical advice. Any advice given is simply what I would do with the information I have on the situation, I do not pretend to have all the answers I am just a knowledgeable source who has done a LOT of research on many different topics. Any help I give directly or otherwise is just that, help from one person to another, if you want medical advice I ADVISE you as a PERSON who cares about other people to see your Doctor, as they will be able to perform the proper tests and deal with you face to face. It is unethical for me to think that I could help anyone without seeing them and I will not bend my rules no matter what the circumstances.




Some references for everyone since I have been better about posting them with my information these days, some of these were posted in the write up but I wanted to throw them on the end as well for easy reference:


http://www.sciencedirect.com/science...39128X9500008E
http://www.ncbi.nlm.nih.gov/pubmed/8539789
https://secure.pharmacytimes.com/lessons/200303-02.asp
http://www.ergogenics.org/anabolenboek/index10en.html
http://www.nutritionj.com/content/6/1/33/
http://onlinelibrary.wiley.com/doi/1...C9179C1.d03t03
http://medicine.iupui.edu/clinpharm/...ct_11_2009.pdf